Patients with a high comorbidity burden (HCB) can achieve similar improvements in quality of life compared with low-risk patients, but greater morbidity may deter surgeons from operating on these patients. Whether surgeon volume influences total hip arthroplasty (THA) outcomes in HCB patients has not been investigated. This study aimed to compare complication rates and implant survivorship in HCB patients operated on by high-volume (HV) and non-HV THA surgeons. Patients with Charlson Comorbidity Index ≥ 5 and American Society of Anesthesiologists grade of III or IV, undergoing primary elective THA between January 2013 and December 2021, were retrospectively reviewed. Patients were separated into groups based on whether they were operated on by a HV surgeon (defined as the top 25% of surgeons at our institution by number of primary THAs per year) or a non-HV surgeon. Groups were propensity-matched 1:1 to control for demographic variables. A total of 1,134 patients were included in the matched analysis. Between groups, 90-day readmissions and revisions were compared, and Kaplan-Meier analysis was used to evaluate implant survivorship within the follow-up period.Aims
Methods
The Forgotten Joint Score-12 (FJS-12) is a validated patient-reported outcome measure (PROM) tool designed to assess artificial prosthesis awareness during daily activities following total hip arthroplasty (THA). The patient-acceptable symptom state (PASS) is the minimum cut-off value that corresponds to a patient’s satisfactory state-of-health. Despite the validity and reliability of the FJS-12 having been previously demonstrated, the PASS has yet to be clearly defined. This study aims to define the PASS of the FJS-12 following primary THA. We retrospectively reviewed all patients who underwent primary elective THA from 2019 to 2020, and answered both the FJS-12 and the Hip Disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS, JR) questionnaires one-year postoperatively. HOOS, JR score was used as the anchor to estimate the PASS of FJS-12. Two statistical methods were employed: the receiver operating characteristic (ROC) curve point, which maximized the Youden index; and 75th percentile of the cumulative percentage curve of patients who had the HOOS, JR score difference larger than the cut-off value.Aims
Methods
In March 2012, an algorithm for the treatment
of intertrochanteric fractures of the hip was introduced in our academic
department of Orthopaedic Surgery. It included the use of specified
implants for particular patterns of fracture. In this cohort study,
102 consecutive patients presenting with an intertrochanteric fracture
were followed prospectively (post-algorithm group). Another 117
consecutive patients who had been treated immediately prior to the
implementation of the algorithm were identified retrospectively
as a control group (pre-algorithm group). The total cost of the
implants prior to implementation of the algorithm was $357 457 (mean:
$3055 (1947 to 4133)); compared with $255 120 (mean: $2501 (1052
to 4133)) after its implementation. There was a trend toward fewer complications
in patients who were treated using the algorithm (33% pre- The implementation of an evidence-based algorithm for the treatment
of intertrochanteric fractures reduced costs while maintaining quality
of care with a lower rate of complications and re-admissions. Cite this article:
